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High Risk of Recurrence or Second Breast Cancer — Managing high recurrence risk of developing a second breast cancer.

hi ladies-can anyone tell me more about what it means if i have "microscopic invasion"? all lymph nodes were neagative, but the docs said i had the invasion in the quotes above. they said "not to worry. it was only microscopic" but what does that mean? did the cancer pass into the blood stream or did it not? i just want to be clear (as possible) on my how it affects my prognosis or chances of mets in the future...(all tests showed no cancer anywhere else)it's a darn complicated disease, no?!

There are many theories about BC. My late husband was an oncologist. He said there was speculation that tumors shed cells from the beginning and that the body's immune system handled them for the most part.Even when they thought I had node negative ILC my onc believed i had circulating cells because I had a large tumor. He did not think I had mets,just the environment for mets to develop. That is the reason chemo or homones are given neo or adj. is given.It is to kill cells that got away and are either active or currently dormant. In my discussions about LIV I have been talking about node positive women. I doubt there are many node positive who do not have LIV.Has anyone seen stage 3 by size, node neg that does not have LIV. That must be very unusual and would meet Love's criteria of a lazy large tumor.Beth

I've met women with mets who never had LVI or positive nodes. We all know that node negative women can and do recur. Things like LVI and nodal status are indicators, not guarantees. In fact, there is a woman on the youngsurvival.org board who got mets after a diagnosis of DCIS (pathology read at two different major cancer centers).

Marianne, I am not a medical professional, but after my diagnosis I jumped head first into researching my disease. I probably didn't end up doing much different than anyone else, but I felt better knowing more about breast cancer and the latest treatments.

I was stage II, multi-focal, with extensive IDC as well as ILC in my breast, as well as extensive LVI, but with a negative sentinal node. I did TAC and a mascectomy, and am now taking tamoxifen (premenopausal and in my 30s upon diagnosis).

The bottom line of the study is that there is some correlation between LVI and survival, but there is more correlation between nodal status, grade of tumor, ER positivity and age of diagnosis. So it's a complex picture.

My best guess is that within five years things like nodal status and LVI are going to be almost completely abandoned as indicators, with genetic testing such as used by the oncotype dx more and more used to stage and guide treatment.

I was diagnosed over 4 years ago. I had LVI and drove everybody crazy trying to get a definate answer on how this would affect me. I also spent hours researching it on the internet. My onco explained it this way to me. They did find it. Cells move and it doesn't mean they are there all the time. Also someone who didn't have on their path report may have had it at some time or another. In the end, this a crazy disease and it doesn't seem like there are easy explanations for many things that happen. I have made it over four years without it returning. I am grateful for everyday and don't spend much time wondering about it anymore.

Tumors cells can break into small vessels seen under the microscope and this is called “vascular” or “lymphovascular invasion”. The presence of tumor in vessels is associated with an increased risk that the tumor has spread outside the breast, although this does not always occur. D2-40 and CD34 are special tests that the pathologist may use to help identify “vascular” or “lymphovascular” or “angiolymphatic” invasion. These tests are not necessary in every case. If your report does not mention this type of invasion, it means it is not present. Even if it is present, your cancer could still be very curable, depending on other factors. How the presence of this finding will affect your specific treatment is best discussed with your treating doctor.